<script type="text/javascript">
function requestMRI() {
	patientElem = document.getElementById("patient_name");
	pubString = "(class patient_req)(name " + patientElem.value + ")";
	publish(pubString, "rmi://localhost:1099/Broker1", true);
}
</script>

<div>
<h3>Publish Client Request</h3>
<form onsubmit="requestMRI()">
<table>
	<tr>
		<td style="font-family: sans-serif;">Patient Name:</td>
		<td><input id="patient_name" type="text" name="patient_name"
			size="20" /></td>
		<td><input type="button" value="Request MRI"
			onclick="requestMRI()" /></td>
	</tr>
</table>
</form>
</div>

<div style="border: 1px solid #ccc;" id="notifications"></div>